| Whole Life Services Llc | |
|
819 Ash St Ste 150 Spooner WI 54801-1201 | |
| (715) 645-0336 | |
| Not Available |
| Full Name | Whole Life Services Llc |
|---|---|
| Speciality | Counselor |
| Location | 819 Ash St Ste 150, Spooner, Wisconsin |
| Authorized Official Name and Position | Gary P Ehrich (DIRECTOR) |
| Authorized Official Contact | 7156450336 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Whole Life Services Llc Po Box 93 Spooner WI 54801-0093 Ph: (715) 645-0336 | Whole Life Services Llc 819 Ash St Ste 150 Spooner WI 54801-1201 Ph: (715) 645-0336 |
| NPI Number | 1396259420 |
|---|---|
| Provider Enumeration Date | 11/28/2017 |
| Last Update Date | 11/28/2017 |
| Medicare PECOS PAC ID | 7517307283 |
|---|---|
| Medicare Enrollment ID | O20240429000506 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396259420 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 1819-132 (Wisconsin) | Primary |
| 324500000X | Substance Abuse Rehabilitation Facility | 11506-135 (Wisconsin) | Secondary |
| Provider Name | Cynthia J Peer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1851732291 PECOS PAC ID: 1557701224 Enrollment ID: I20240429000671 |
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